Siezing The Advantage

There is no doubt, for me, that the services called "health care" in this country are imperfect and in need of attention. There are conservatives who seem to deny reality; for instance, when they claim that, because emergency rooms refuse no one, health care is available to everyone. Well, ER treatment isn't health care, and the implication that it amounts to universal coverage is ludicrous. But for a long time, most conservative pundits had this, or no, response to the left's creepy single-payer absolutism, and the practical emptiness on our side ceded the moral high ground to The Left.

We still don't know what the Republican alternatives to ObamaCare might be, except that they include medical savings accounts and intra-state competition for insurance providers. But where ObamaCare has the merit of theoretical and moral elegance because it works on paper, in flow charts, and promises to address real human needs - conservative solutions still seem like carpet tacks in a tornado. But ObamaCare is still losing. Why?

That ObamaCare is as unpopular as it is, must be attributed to something other than lucidity on the part of Republicans, or the proposals of talk-radio personalities. I think it's this: the deep politicization of all facets of American life over the past forty years has finally reached saturation. Millions of people now find themselves outside the generation-long default mode of liberal thinking, on all social issues. It's the end of The Great Society's assumption that The System is at fault; the driver of all individual disadvantage, deprivation and want. Once you force changes to The System, you eliminate the problems.

The reverse of this idea of social forces as destiny is the Dickensian idea that all misery, injustice and grief is the result of deficits of character. The innocent sufferer trapped in poverty was, usually, the pawn of someone much worse than he, but that no changes to The System would overcome the quality of the people who managed it, i.e., those in power. This is closer to the conservative view of life. It assumes that the evolved systems of association, church, fraternal organizations, school discipline and all the unofficial ways that populations devise to help one another are better at everything than government.

These are old ideas; they revived because their time came back round, and they existed before the arguments over universal health coverage began. They coalesced when the socialization of medicine became a real possibility. They need to be cultivated in that context because that's where they're expressing themselves at the moment.

Until some courageous figure on The Right makes a coherent moral case - and it is a moral case - for providing health coverage to the involuntary uninsured and liberating the power of the consumer, a case that doesn't have the charm of double-entry bookkeeping but ignites the listener with a righteous purpose, The Left will have the advantage. You can never overestimate the power of their sanctimony to pull them together and stampede them like cattle in the same direction. Once you've proven yourself to be better than they are, they've got nuthin'.